The line between sanity and insanity

I just finished The Great Pretender by Susannah Cahalan and IT WAS SO GOOD. I don't know why I am surprised by how much I truly enjoy reading an excellent nonfiction book but it's always such a delight especially when they're as engrossing as this one. You might recognize Susannah Cahalan as the author of Brain On Fire about her experiences being misdiagnosed with psychosis (for a MONTH) before a doctor determined it was actually autoimmune encephalitis. From that experience, Cahalan became a kind of spokesperson for this disease as well as an advocate for a more nuanced and structured diagnostic process. She learns about a well-known study conducted in the early 70s by David Rosenhan which explored the (pseudo)science of psychiatric diagnosis and the environment of psychiatric hospitals. And thus her passion was truly ignited as she worked to track down as much information about this study as possible. The explosive (and controversial) results of this landmark study had a profound effect on the field of psychiatry and how we view and treat mental illness in the United States. Cahalan gives a comprehensive overview of psychiatry and her journey to uncover the identities of those that participated in the original study. The end result was this book which I frankly keep raving about to anyone who will stop long enough to listen to me. Go forth, dear reader! 10/10

Source: Amazon

What I'm currently reading: The Poisoned City by Anna Clark

**If you're interested in buying any of these books or any books really, you can click here. This will re-direct you to AbeBooks which is a site I use all of the time to find used books at an excellent price. A lot of the time I don't even pay for shipping! Full disclosure: I will receive a commission on all sales made through this link. You will not be charged anything additional for my commission. I wouldn't recommend a site that I didn't use and you are under no obligation to purchase anything. :-) **

The argument for palliative care

"...our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality. ...you live longer only when you stop trying to live longer." - pg 178

I wanted to start with that quote from today's book because it struck me as being so shocking in its simplicity and yet it completely blindsided me with its poignancy. Being Mortal: Medicine and What Matters in the End by Atul Gawande is at heart a discussion of the ups and downs of treating the elderly through a variety of means whether that means aggressive medicine, nursing homes, assisted living, or hospice. It's obvious that the author has a great admiration for palliative care and a belief that all doctors/clinicians should be trained and proactive to deliver the best care for their patients. In essence, asking practical questions about what trade-offs patients are willing to make for ensuring good days ahead are key to excellent palliative care (for any age). He stresses that instead of simply giving all the options for care at the outset of a diagnosis doctors should instead ask a set of pertinent questions to get at what their patient really wants to have a good quality of life. This is relevant (and necessary) for patients whether they be elderly, terminally ill, or disabled. Gawande clearly knows his stuff (he is a doctor after all) and he was thorough in his research for this book as he interviewed across many disciplines to see what is being done by various agencies in the care of the elderly and dying. Apparently there is no one accepted method of care except to ask, listen, and respect the wishes of patients. According to Gawande, there is "...a still unresolved argument about what the function of medicine really is - what, in other words, we should and should not be paying for doctors to do." (pg 187) Hospice is not just an option for those who are looking for end of life help or to speed up death but is an excellent choice to make good days out of one's remaining life. My verdict: Very informative book that I kept picking up with great alacrity and I will definitely read more of his writing. 10/10

I'll leave you with this final quote to chew over:

"At root, the debate is about what we fear most - the mistake of prolonging suffering or the mistake of shortening valued life. All the same, I fear what happens when we expand the terrain of medical practice to include actively assisting people with speeding their death." - pg 244  

Source: Amazon

What's Up Next: The Science of Superheroes by Lois H. Gresh & Robert E. Weinberg

What I'm Currently Reading: The Bear and the Nightingale by Katherine Arden

**If you're interested in buying this book or any books really, you can click here or here. The first will re-direct you to AbeBooks and the second will re-direct you to The Book Depository. These are great websites for purchasing books (AbeBooks carries inexpensive used and out-of-print books and The Book Depository ships free everywhere in the world). Full disclosure: I will receive a commission on all sales made by following either of these links. I wouldn't recommend a site that I didn't use and you are under no obligation to purchase anything. :-) **

Raw, unfiltered, and achingly honest

When Breath Becomes Air by Paul Kalanithi is a posthumous memoir/biography from a man who was both in the prime of his life and the beginning of what promised to be an illustrious career as a neurosurgeon and neuroscientist. The terminal lung cancer which was already making its way through his spinal column wasn't part of the plan...and yet Paul chose to meet this challenge head-on as a way to understand and learn how the inevitability of death can be explored by those shepherding the way. How does the mind and brain (seen as two separate entities here) play a role in this? He first approached this topic through the lens of literature which he had always been interested in (hence the beginning of the book which would eventually be published after his death) but he then moved on to his direct experience as a doctor and then as a patient. Paul was interested in the bigger picture of what exactly death means and he kept trying to parse it out by asking, "Where did biology, morality, literature, and philosophy intersect?" (pg 41). He didn't shy away from the ugly underbelly of cancer treatment and how it's seen from both a medical professional's standpoint (best practices, proven remedies, etc) and the one receiving the care (uncertainty, despair, anger, and frustration to name a few). Facing mortality and asking the tough questions are the overarching themes of When Breath Becomes Air but this is also a quiet story about a man coming to terms with the fact his life was about to end. I don't want to give away all of the details because I really think you should read this one if you never read another book about death (although why stop here?). I didn't know if I'd be able to continue it at several points (there were tears) because it mirrors so much of what my dear friend, Jessica, went through during her battle with cancer. But I am happy that I persevered. 10/10

This quote blew my mind because I feel I'm constantly justifying to people why I do the work that I do even though some of it doesn't compensate me at all (the blog) and the one that does is probably never going to make me financially solvent (children's librarian). Looking at the bigger picture is hard if you are cutting out the crucial bits like death which comes for us all.

Indeed, this is how 99 percent of people select their jobs: pay, work, environment, house. But that's the point. Putting lifestyle first is how you find a job - not a calling. - pg 68-69

If I remember correctly this was a quote from Paul's wife and I think it perfectly encapsulates why this is such an important book. It's why I've read and reviewed so many books around this topic over the past year.

Paul confronted death - examined it, wrestled with it, accepted it - as a physician and a patient. He wanted to help people understand death and face their mortality. Paul's decision not to avert his eyes from death epitomizes a fortitude we don't celebrate enough in our death-avoidant culture. - pg 215

Source: Amazon

Side note of interest (at least to me): Lucy, Paul's widow, found love again with a recently widowed father of two...who's spouse also wrote a book about her journey of dying. That book is The Bright Hour: A Memoir of Living and Dying by Nina Riggs and yes it's totally going on my TRL.

What's Up Next: Being Mortal: Medicine and What Matters in the End by Atul Gawande

What I'm Currently Reading: The Bear and the Nightingale by Katherine Arden

**If you're interested in buying this book or any books really, you can click here or here. The first will re-direct you to AbeBooks and the second will re-direct you to The Book Depository. These are great websites for purchasing books (AbeBooks carries inexpensive used and out-of-print books and The Book Depository ships free everywhere in the world). Full disclosure: I will receive a commission on all sales made by following either of these links. I wouldn't recommend a site that I didn't use and you are under no obligation to purchase anything. :-) **

Ever wondered about the anatomy of a leech?

As soon as I saw Quackery: A Brief History of the Worst Ways to Cure Everything by Lydia Kang I knew that I had to get it in my hands. If the name alone doesn't intrigue you then I don't know what will. This book is full to bursting with historical facts about crazy medical practices through the ages. It is an excellent resource about the history of the medical profession as well as education and social change. Much like when I read Soonish, I felt that it was a little heavy with the 'relatable' humor but this was easily overlooked. (I think Kang pulled it off better anyway.) As someone who has read quite a bit about the history of medicine, I was surprised by just how much I didn't know. For example, did you know that leeches have 3 stomachs, 3 jaws, and 100 teeth in each of those jaws?! Kang sets up the different medical practices and procedures by first giving a history of the person that started it off (generally a 'medical practitioner' or someone at least purporting to be one). She then shares accounts from the patients who endured such crazy routines (like bloodletting or ingesting arsenic) paired with diagrams of the medical equipment used to accomplish such feats. (I hope you have a strong stomach for the bloodletting chapter.) I especially enjoyed the little asides about what we now know about the concoctions put together long ago to 'cure' and how the vast majority of them were either complete hokum or actually increased the chances of the patient suffering an agonizing death. It makes you wonder how the future generations will view our supposedly 'innovative' medicines and treatments of the sick. Will we be seen as medical charlatans and blind fools or will they take into account the socioeconomic and political climate that we live in and how that shapes our view on medicine as a whole? As you read this book (and I hope you will) ponder that very question because then perhaps you won't judge past generations quite so harshly...unless it's the guys who took Strychnine in order to increase their sex drive. Always judge those guys. 9/10

Source: Amazon

I wasn't lying about the leeches. [Source: Amazon]

What's Up Next: HiLo Book 4: Waking the Monsters by Judd Winick

What I'm Currently Reading: The Murderer's Ape by Jakob Wegelius

**If you're interested in buying this book or any books really, you can click here or here. The first will re-direct you to AbeBooks and the second will re-direct you to The Book Depository. These are great websites for purchasing books (AbeBooks carries inexpensive used and out-of-print books and The Book Depository ships free everywhere in the world). Full disclosure: I will receive a commission on all sales made by following either of these links. I wouldn't recommend a site that I didn't use and you are under no obligation to purchase anything. :-) **